Smoking is a cause of liver cancer and colorectal cancer, the fourth-most-diagnosed form of the disease in the United States, Acting Surgeon General Boris D. Lushniak found in a report released Friday. In addition, he said, smoking is a cause of Type 2 diabetes mellitus, age-related macular degeneration, erectile dysfunction and rheumatoid arthritis. It can impair the immune system, worsen asthma and cause cleft lips and palates in fetuses. And exposure to secondhand smoke can cause strokes.

Smokers today have a much higher risk of developing lung cancers than did smokers in the 1960s, probably because of changes in the design and composition of cigarettes over time, according to the findings.

Friday’s report, the latest of more than 30 such documents issued by surgeons general since the landmark 1964 examination of smoking’s health consequences, offered another round of evidence of tobacco’s potential to harm nearly every human organ.

“The conclusions from these reports have evolved from a few causal associations in 1964 to a robust body of evidence documenting health consequences both from active smoking and exposure to secondhand smoke across a range of diseases and organ systems,” Lushniak wrote of the findings. “A half century after the release of the first report, we continue to add to the long list of diseases caused by tobacco use and exposure.”

There’s little doubt that the decades of public health efforts to educate Americans about the dangers of smoking, as well as a sustained push for tighter tobacco controls, have produced tangible results.

Cigarette smoking has continued to decline among adults, from 42 percent in 1965 to 18 percent in 2012. The United States now has more former smokers than current smokers.

All told, anti-smoking measures have spared an estimated 8 million lives in the country over the past 50 years and contributed to longer life expectancies, according to a study released last week by the Journal of the American Medical Association. A far-reaching law enacted in 2009 also gave the Food and Drug Administration the power to regulate cigarettes and other tobacco products for the first time.

Since 1964, more than 20 million Americans have died prematurely from smoking, and tobacco use remains the leading cause of preventable death in the United States. The Centers for Disease Control and Prevention estimates that 443,000 Americans die each year from smoking-related illnesses, and each day, thousands of teenagers try their first cigarette.

In addition, the direct medical costs of smoking add up to more than $130 billion per year, along with $150 billion a year in productivity losses from premature deaths, according to Friday’s report.

Last week, a collection of public health and anti-tobacco groups, including the American Academy of Pediatrics and the American Heart Association, collectively called for a “new national commitment” to eliminating tobacco-related deaths. Among their suggestions: tobacco tax increases, broader laws for smoke-free workplaces, strict tobacco oversight from the FDA, and aggressive advertising campaigns to help smokers quit and keep nonsmokers from lighting up.

“It’s a winnable fight,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids. “We actually have the policies and programs to end the tobacco epidemic, and they don’t cost so much they can’t be implemented quickly.”

Friday’s surgeon general report supports those actions and others, even as it notes that “the current rate of progress in tobacco control is not fast enough.” It cites significant public-health victories in the past, such as the eradication of smallpox and polio, saying that the elimination of tobacco-related death and disease deserves a similar level of commitment from every corner of society.

Brady Dennis is a national reporter for The Washington Post, focusing on food and drug issues.

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